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The pandemic was a chance for the Centers for Disease Control and Prevention to do what it does best.

Instead, that public health crisis left the CDC marred by political interference and 

Trust is clearly one issue on the mind of the agency's new director, Dr. Mandy Cohen. She mentioned the word more than 50 times at a commencement 

"Trust is a critical foundation for a healthy society," she said. "Trust in institutions, such as government, or media, or business, has been eroding in recent years. This lack of trust has led to polarization, to division."

Cohen is an internist who led the North Carolina Department of Health and Human Services during the pandemic, and as of last month she is director of the CDC.

 Sacha Pfeiffer about what comes next for the CDC.

The following interview has been lightly edited for length and clarity.

During COVID, you were a top state public health official. Are there any key lessons you learned from that that you'll try to apply to your federal job?

Well, it was an honor to serve North Carolina through the COVID crisis. And I think that we were able to be successful in our response effort because we put trust at the center and we worked on being transparent. 

We worked on making sure that we delivered for the people of North Carolina and that we built relationships. We built them with historically underserved communities. We built them with our hospital system, so that we executed as a team and did our work as a team. 

And importantly, we worked across the aisle. And this is where Congress and others are important partners in all of this. This is a team sport to protect folks' health. I think that's why North Carolina was successful. And I'm definitely going to bring those lessons learned here to the CDC.

Two years into the pandemic, there was a survey in which a quarter of the respondents said that they trusted the CDC "not very much" or "not at all." How do you plan to try to rebuild trust with people in the U.S.?

Well, I think there's really three important steps. First is making sure that we are being transparent. We're having clear communications that are simple and accurate, that folks can understand, that they know that there are common sense solutions for them to protect their health. 

And the second is making sure that we execute or have good performance in what the CDC is meant to do. And so making sure that we are doing what we say we're going to do. Just as you trust in your own personal life, I want to make sure that you trust that we are going to to do that for you.

And the third, very important, is about building relationships and partnership. Protecting the health of this country is a team sport. And so those are that we need to bring partners together in order to protect people's health. We can't do it alone from the CDC.

During COVID, the CDC and public health officials now acknowledge they didn't have all the answers, but sometimes they wanted to sound authoritative. And then later, their messaging changed. I'm wondering if you think that instead public health officials should sometimes say, "We don't know the answer." 

I think it's important to be clear about what you know, what you don't know, and what you're working on. Science and data is going to be constantly evolving. 

We know some things on a certain day, and then we may learn new things that change how we think about things. So we want to be clear. We want to be simple, we want to be repetitive, but we have to also make sure we're telling folks that this could change. And so that's what I'm going to focus on with my team here at the CDC is making sure that we are communicating, "This is what we know today. And we will continue to update you as we learn more."

Beyond COVID, the CDC has so many issues it could focus on: obesity, opioids, rising numbers of STDs, shortage of public health workers, fighting conspiracy theories. What would you say you would like your major direction or focus to be for the agency?

What you're going to see [as a] first focus for me is certainly to make sure we are ready for this fall and winter virus season.

The good news is that we have more tools than ever before to fight COVID, flu and RSV. We have vaccines, we have testing, we have treatment. But we need to use all those tools to make sure that folks are protecting their health.

As you know, we have a great deal of not just vaccine hesitancy and not just vaccine resistance, but vaccine hostility in our country. Do you have any thoughts for how the CDC can change people's minds on that?

I think that fundamentally goes back to to trust and how we can rebuild trust, not just in CDC, but in institutions, in media, in science overall. Again, I think that focuses on being transparent, doing a good job of performing each and every day, doing our jobs and making sure to build relationships.

You actually think you can make progress there? Do you think you could change minds?

I think so. And we saw that happen in North Carolina while I was serving as secretary of Health and Human Services. We actually saw trust go up in the department over the time we were responding to the COVID crisis. And we also saw a very high rate of vaccination. 

We actually saw more than 99 percent of seniors over the age of 65 get vaccinated in in North Carolina, despite us being a politically divided state, very urban and rural, racially diverse. So I think it can be done. 

Sacha Pfeiffer

Author

Megan Lim

Christopher Intagliata

Mandy Cohen led North Carolina's department of Health & Human Services throughout the pandemic. Now, she's taking what she learned to the national level.

The new CDC director outlines 3 steps to rebuild trust with the public

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